Baby Toes

Does Bariatric Surgery Make Pregnancy Safer?

Obesity presents many challenges, but perhaps some of the most troubling can be with pregnancy. It can make getting pregnant more difficult. Also, it can lead to complications in pregnancy. So the news that obesity treatment in the form of bariatric surgery might make pregnancy safer is good news indeed.

An Observational Study

First and foremost, we must note that this most recent study is observational. Ibi Ibiebele and colleagues studied the hospital records for 1.6 million women in New South Wales, Australia. They found a large, 13-fold increase in bariatric surgery between 2002 and 2014.

They also looked closely at 326 women who had bariatric surgery between a first and second pregnancy. And that’s where they found the good news. In the second pregnancies, they found lower rates of problems. Less hypertension, fewer preterm births, and fewer admissions to neonatal intensive care. Smoother pregnancies and births.

Of course, this study is observational. It helps that each patient serves as her own control. Nonetheless, bariatric surgery in this study is not a randomized intervention. It could be that other factors influence the choice to have surgery and those factors are responsible for the better outcomes on the second surgery.

Obesity and Pregnancy

Right now, young women who want to have children may or may not have good access to obesity care. But it’s becoming ever more clear that this makes no sense. Mothers with untreated obesity are more likely to have children with obesity. Research has shown that rates of birth defects are lower when a mother has had bariatric surgery. We’ve even seen that surgery can have epigenetic effects with the potential to reduce the genetic risk of obesity in offspring.

Thus, offering better obesity care to potential mothers may be an important way to prevent obesity in the next generation. The die is cast early and thus, access to good obesity care can prevent many problems down the road.

Click here for the study by Ibiebele et al and here for further reporting on it.

Baby Toes, photograph © Joyell VanGelder / flickr

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December 8, 2019